Samur-Eye Champloo (narrated)

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Play, download and edit the free video Samur-Eye Champloo (narrated).

This video was to be featured in the 2020 Vit Buckle Society "Master of Disaster" complication video contest. It features the left eye of a 79 year-old female who presented with total retinal detachment secondary to large, full-thickness macular hole. A standard 27g vitrectomy with ILM peeling (over detached retina), air-fluid exchange, and prolonged gas tamponade was performed initially. Despite successful retinal reattachment, the gaping hole failed to close. As the patient's ILM had already been generously peeled during the first surgery, my options for hole closure were few (and unappealing). Some advocate intentional macular redetachment (with subretinal saline), however this did not figure to be promising as the retina was fully detached and mobile at the time of first surgery; hinged ILM "flapping" would likewise prove impossible, as I generously peeled ILM from the entire macula during the first case. And so -- no fan of autologous retinal transplantation (and not yet convinced that amniotic membrane is up to snuff -- I resorted to a technique that I have used some half dozen times with much success: anterior capsular lens transplantation (vimeo.com/chrisfullermd/capsulartransplant). One hiccup: in my previous such cases, I had the benefit of harvesting capsule from a phakic eye. Not so in this case, as my patient was for some time pseudophakic. And so, she was ferried to her cataract surgeon for CE/IOL in her fellow eye; at the time of that surgery, anterior lens capsule was carefully collected and preserved (in refrigerated saline) for its use in my surgery some two days later. As you will note in the video, we enjoyed initial visual and anatomic success. This, however, proved short-lived, as the graft began to dislodge after one month, ultimately resulting in total retinal redetachment.

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